The main purpose of this study was to examine trends in functional ability and health behaviours and associations between these factors among a nationwide sample of elderly people in Finland from 1985 to 2003. In addition, sociodemographic variations in functional ability and health behaviours were assessed.

This study showed improving functional ability of the elderly people at the national level in both sexes from the mid-1980s to the start of the new millennium. The most marked improvement was observed among 65-69-year-old respondents. Retired office employees had better functional ability than other occupational groups throughout the monitoring period. Ex-farmers had the poorest functional ability in both genders. Occupational disparities in functional ability changed slightly over time, and more positively among men than women. Married persons were found to have slightly better functional ability than non-married individuals.

The number of people in Finland aged 65 and over will rise by approximately 70% over the next 30 years. The increasing burden on health and social services due to the ageing population prioritizes the study of factors that promote “active ageing”. Functional ability and modifiable health behaviours are vital topics for research, as they have clear associations with multiple health outcomes. As functional ability in later life is largely determined by health behaviour, it is also important to examine both in the same context.

The study was carried out mainly in the Health Promotion Research Unit of the Department of Epidemiology and Health Promotion in the National Public Health Institute (KTL). The study is also a academic dissertation for University of Helsinki, Faculty of Social Sciences, Department of Social Policy.

From 1985 to 2003, the functional ability and health behaviours of 13 232 men and women of the 65-79-year-old Finnish population were monitored in biennial crosssectional surveys. The average response rate exceeded 80%. Self-reported activities of daily living (ADL) were used to study functional ability.

The indicators of health behaviours were diet, smoking, use of alcohol, physical activity and body mass index. Self-reported chronic diseases were controlled for when examining obesity trends and associations between functional ability and health behaviours.

Sociodemographic variations were studied in terms of age group, main occupation before retirement, and marital status. Age-adjusted trends, and logistic and ordinal regression analyses were computed to derive the results. 

These days elderly Finnish people eat healthier food and smoke slightly less than their age-matched counterparts a couple of decades ago, but they use more alcohol and are more likely to be obese. The study findings show that healthy diet, smoking and alcohol consumption were less prevalent among the oldest respondents. Healthy diet and higher alcohol consumption increased in all occupational groups over time and were more pronounced among retired office workers than other former employees.

Alcohol consumption among male and female ex-farmers and smoking among female ex-farmers were at low levels throughout the study period. Healthy diet was more prevalent among married than non-married elderly people, whereas smoking was twice as prevalent among the non-married.

An upward trend of obesity was observed in all sociodemographic groups from the mid-1980s to the early 2000s. The lowest prevalence of obesity was observed among the oldest respondents and former office employees. Widowed women had a slightly higher prevalence of obesity than married women. Marital status disparities in obesity among men were minor.

Current and ex-smoking, both heavy- and non-alcohol use, unhealthy diet, physical inactivity and obesity were all associated with inferior functional ability. Alcohol consumption showed a U-shaped relation to ADL difficulties. Health behaviours and chronic diseases mediated sociodemographic differences in functional ability.

The trend of enhanced functional ability together with some improvements in health behaviour indicates a healthier future for elderly people in Finland. Despite these advances, however, sub-group disparities persist. Together with the apparently rising prevalence of alcohol use and obesity, these disparities are challenges for public health.

National Public Health Institute (KTL)
Finland
http://www.ktl.fi
Tommi Sulander (Researcher), tel. + 358 9 4744 8808

01/03/2005

Tommi Sulander

research

Urban Policy > Social inclusion & integration > Quality of life

Health, Social services